An Overview of Positive Homeopathy Research and Surveys

This document has been produced by the European Network for Homeopathy Researchers (ENHR). The ENHR was established in 2004 with support from the European Council for Classical Homeopathy (ECCH). ECCH currently assists the ENHR in its secretarial work. The ENHR consists of 55 individuals from 14 different countries involved in or with a special interest in homeopathy research. The ENHR is open to membership for any individual involved or interested in homeopathy research.

Purpose of the European Network of Homeopathy Researchers (ENHR):

The primary aim of the ENHR is to contribute to improving homeopathy research for the benefit of patients.

A long-term objective of the ENHR is to contribute to carrying out international EU funded research projects within the area of homeopathy research.

The ENHR consists of researchers, research advisors and representatives of the homeopathy profession as well as consumer/patient groups with an interest in the area of homeopathy research.

Members of the ENHR inform each other about homeopathy research that is in the planning stages or being carried out, as well as published research articles.

Introduction

This document contains a sample of brief summaries of positive homeopathy research, together with the full references. Additional information may be found in the document entitled ‘Facts about homeopathy and other CAM therapies’ (an ECCH document), and on the enclosed list of website addresses. Readers are recommended to read the full research articles in order to acquire a more profound knowledge base of research that has been undertaken.

Contents Page

Use of homeopathy and other CAM therapies

User surveys showing patient satisfaction with homeopathic treatment

Meta-analyses

Key trials and surveys

Diarrhoea in children

Respiratory tract complaints

Musculo-skeletal problems

Hay fever, asthma and perennial rhinitis

Pre menstrual syndrome (PMS)

Homeopathy in menopausal complaints

Homeopathy and oestrogen withdrawal

ADHD

ME/CFS

Surgery

Dengue haemorrhagic fever

Cost benefit

Basic research – The effect of high dilutions

Treatment of animals

Research website addresses

USE OF HOMEOPATHY AND OTHER CAM THERAPIES

Homeopathy is being practised in 41 out of 42 European countries.

The Legal Situation for the Practice of Homeopathy in Europe, revised report, May 2006, European Council for Classical Homeopathy. Legal Status of Traditional Medicine and Complementary/ Alternative Medicine: A Worldwide Review, World Health Organization, 2001.

Homeopathy is the most frequently used CAM therapy in 5 out of 16 surveyed countries in Europe and among the three most frequently used in 11 out of 16 surveyed countries.

Three Europeans out of four know about homeopathy and of these 29 % use it for their health care.

Homeopathic medicinal products. Commission report to the European Parliament and the Council on the application of Directives 92/73 and 92/74.

A study of 1097 patients visiting 80 Norwegian homeopaths showed that one in four patients were children between 0 and 9 years of age, compared to one in ten in 1985 and in general practice. The most commonly presented complaints were respiratory, skin and psychological complaints.

A survey of 1400 patients treated in a homeopathic clinic showed that 36 % were under the age of 16 in 2004, compared to 26 % in 1995. Respiratory complaints, complaints of ears and skin accounted for 70 % of patients in the age group from 0 to 10 years. More than half of the patients had university or other higher education.

A survey of more than 70,000 citizens showed that approximately 9 million people in Italy (15.6 % of the population) have used at least one unconventional therapy in the period from 1997 to 1999. Homeopathy was the most frequently used (8.2 % of the population). Homeopathy was also quite commonly used by children (7.7 %). The use of CAM therapies has almost doubled since 1991.

In an observational study of 6544 consecutive patients during a 6-year period, and over 23,000 consultations, results showed that 70.7 % reported positive health changes, with 50.7 % recording their improvement as better (+2) or much better (+3). Of the 1270 children that were treated 80.5 % had some improvement, and 65.8 % were better (+2) or much better (+3).

In a prospective, multi-centre cohort study with 103 primary care practices treating 3981 patients, disease severity decreased significantly (p<0.001) over a 2 year period. Major improvements were observed for quality of life for adults and young children. 28 % (1130) of the patients were children and 97 % of all diagnoses where chronic with an average duration of 8.8 years. The most frequent diagnoses were allergic rhinitis in men, headache in women, and atopic dermatitis in children.

One year after their first visit to a homeopathic clinic, 609 patients were asked to rate their general health compared with a year ago. 73.5 % reported a marked or moderate improvement in their health status.

A survey of more than 900 patients treated homeopathically showed substantial improvement in quality of life over the first 6 months after treatment and this effect remained more or less stable over the following years.

The effect of homeopathy, acupuncture and osteopathy. Result: 89% of patients stated they experienced positive effect from the treatment. Particularly clear effect on reduction of pain, increased vitality, ability to function socially and with regards to limitations at work and in daily activities influenced by physical problems. Homeopathy was particularly effective for patients suffering from arthritis, hay fever, asthma and skin complaints.

Richardson J. Quasi-randomised control trial to assess the outcome of acupuncture, osteopathy and homoeopathy using the short form 36 item health survey. Health Services Research and Evaluation Unit, The Lewisham Hospital NHS Trust. December 1996.

REVIEWS AND META-ANALYSES

A meta-analysis is a means of combining results from more than one trial to look for overall trends. (NB! In general complicated research terminology such as OR, CI, and words such as significant or randomized should only be used in communications with people who will understand such terminology. Otherwise stick to what can be understood by all, e.g. a survey of all the high quality research that has been carried out clearly shows that homeopathy is effective.)

Results were found in favour of homeopathy in 20 of 22 systematic reviews on the effect of homeopathic high-potencies on cells or living organisms. For upper respiratory tract infections and allergies six out of seven studies were in favour of homeopathy. The authors of this article concluded that the effectiveness of homeopathy can be supported by clinical evidence and treatment is safe. The article has been published by authors who took part of the Program for Evaluation of Complementary Medicine (PEK), the same program which in August 2005 resulted in the publication of an article by Shang et al, where the conclusion was that the effect of homeopathy is placebo.

In a review of homeopathy research the authors found three independent systematic reviews of placebo-controlled trials on homeopathy that reported effects that seem to be more than placebo, and one review that found its effects consistent with placebo.

A systematic review and meta-analysis showed highly significant results for surveys adding up to a total of 2 617 patients (P=0.000036). Results were not that significant for high quality surveys (P=0.08). The author concludes that further high quality studies are needed to confirm results.

A systematic review of results from 93 substantive RCTs was carried out by Robert Mathie (2003). It concludes that of the 35 different medical conditions covered by these trials the weight of evidence favours a positive treatment effect in 8: childhood diarrhoea, fibrositosis, hay fever, influenza, pain (miscellaneous), side-effects of chemotherapy or radiotherapy, sprains and upper-respiratory tract infections.

Mathie, R. The research evidence base for homeopathy: a fresh assessment of the literature. Homeopathy 92: 84-91. 2003.

Meta-analysis of 89 trials of homeopathic medicine versus placebo. Result: significantly in favour of homeopathy (OR 2,45 (95% CI 2,05-2,93)). This meta-analysis included 186 placebo-controlled studies of homeopathy published until mid-1996, of which data for analysis could be extracted from 89. The overall odds ratio was 2.45 (95% confidence intervals 2.05-2.93) in favour of homeopathy, which means that the chances that homeopathy would benefit the patient were 2.45 times greater than placebo. When considering just those trials of high quality published in MEDLINE listed journals, and with predefined primary outcome measures, the pooled odds ratio was 1.97 and significant. Even after correction for publication bias the results remained significant. The main conclusion was that the results “were not compatible with the hypothesis that the effects of homeopathy are completely due to placebo”. If the result of new trials were to show no difference between homeopathy and placebo, we would have to add 923 trials with no effect with 118 patients in each in order to balance the two.

HMRG report with overview of clinical research in homeopathy, identified 184 controlled clinical trials. They selected the highest quality randomized control trials, which included a total of 2617 patients for a meta-analysis. This meta-analysis resulted in a p-value of 0.000036 (which means that results are highly significant) indicating that homeopathy is more effective than placebo. The researchers concluded that the “hypothesis that homeopathy has no effect can be rejected with certainty”. Homeopathic Medicine Research Group.

Report to the European Commission directorate general XII: science, research and development. Vol 1 (short version). Brussels: European Commission, 1996:16-7.

Of the 105 trials with interpretable results, 81 trials indicated positive results. Most studies showed results in favour of homeopathy even among those randomized controlled trials that received high-quality ratings for randomization, blinding, sample size, and other methodological criteria. They came to the following conclusion: “The amount of positive evidence even among the best studies came as a surprise to us. Based on this evidence we would readily accept that homeopathy can be efficacious, if only the mechanism of action were more plausible. The evidence presented in this review would probably be sufficient for establishing homeopathy as a regular treatment for certain indications”.

A health technology assessment report on effectiveness, cost-effectiveness and appropriateness of homeopathy was compiled on behalf of the Swiss Federal Office for Public Health. Results showed a positive overall result in favour of homeopathy in 29 studies on upper respiratory tract infections and allergic reactions. Results also showed many high-quality investigations of pre-clinical basic research proved homeopathic high-potencies inducing regulative and specific changes in cells or living organisms. 20 of 22 systematic reviews detected at least a trend in favour of homeopathy.

A review of placebo-controlled clinical trials using homeopathic medicines to treat people with AIDS or who are HIV-positive found 5 controlled clinical trials. Results showed statistically significant results in subjects with stage III AIDS, and specific physical, immunologic, neurologic, metabolic, and quality-of-life benefits, including improvements in lymphocyte counts and functions and reductions in HIV viral loads in patients receiving homeopathic treatment.

This trial involved 81 children aged from 6 months to 5 years in a randomised, double-blind trial of intravenous fluids placebo versus intravenous fluids homeopathic remedy individualised to the patient. The treatment group had a statistically significant decrease in duration of diarrhoea.

In a replication of a trial carried out in Nicaragua in 1994, 116 Nepalese children aged 6 months to 5 years suffering from diarrhoea were given an individualised homoeopathic medicine or placebo. Treatment by homoeopathy showed a significant improvement in the condition in comparison to placebo.

This meta-analysis of 242 children showed a highly significant result in the duration of childhood diarrhoea (P=0.008). It should be noted that the World Health Organisation consider childhood diarrhoea to be the number one public health problem today because of the millions of children who die every year from dehydration from diarrhoea.

In an outcome study, 30 practitioners in four countries enrolled 500 consecutive patients with at least one of three complaints: upper respiratory tract complaints including allergies; lower respiratory tract complaints including allergies; or ear complaints. Of 456 patients, 281 received homeopathy and 175 conventional treatment. The primary outcome criterion was response to treatment, defined as cured or major improvement after 14 days of treatment. Results showed a response rate of 82.6% in the homeopathy group compared to 67.3% in the group receiving conventional medicine. The authors concluded that homeopathy appeared to be at least as effective as conventional treatment of patients with the three conditions studied.

Prospective observational study, comparison of homeopathy versus conventional treatment in acute otitis media. Conclusion: homeopathy should be first line treatment in acute otitis media. Results showed median duration of pain of 2 days in the homeopathy-group and 3 days in the conventional medicine group. 70.7 % of the children receiving homeopathic treatment did not have another ear infection the next year and 29.3 % had a maximum of three ear infections within one year. 56.5 % in the conventional medicine group did not have another ear infection the next year and 43.5 % had a maximum of six ear infections the next year. Results showed that in the group receiving homeopathic treatment only 5 out of 103 children needed antibiotics.

A study involving children suffering from acute otitis media suggests that a positive treatment effect from homeopathy when compared with placebo in acute otitis media cannot be excluded. There were fewer treatment failures in the group receiving homeopathy after 5 days, 2 weeks, and 6 weeks, with differences of 11.4, 18.4, and 19.9%, respectively, but these differences were not statistically significant. Diary scores showed a significant decrease in symptoms at 24 and 64 h after treatment in favour of homeopathy (P<0.05).

In a trial of 230 children who were given homeopathic treatment to treat acute otitis media, pain relief was achieved in 39% of the patients after 6 h and another 33% after 12 h. The resolution rates were 2.4 times faster than in placebo controls. No complications were observed and compared to conventional treatment the homeopathic approach was 14% cheaper.

In a pilot study in children suffering from glue ear treated with homeopathy 75% had normal tympanogram, compared to 31% in the group treated with conventional medicine. A higher proportion of children receiving homeopathic treatment had a hearing loss less than 20 dB at follow-up, though the difference was not statistically significant. The authors concluded that further research comparing homeopathy to standard care is warranted; 270 patients would be needed for a definitive trial.

In an uncontrolled clinical trial of 119 patients suffering from clinical signs of acute sinusitis were treated using homeopathic medicines. Typical sinusitis symptoms, such as headache, pressure pain at nerve exit points, and irritating cough, were reduced after a mean of 4.1 days of treatment. Ninety-nine received only a homeopathic test medication, 20 patients were able to discontinue concomitant medication at the first visit, and only one patient needed antibiotics. Average duration of treatment was 2 weeks. At the end of treatment 81.5 % described themselves as symptom free or significantly improved. No adverse medication effects were reported.

Forty-six patients with rheumatoid arthritis received an individualised remedy or placebo in a 3-month randomised trial. Both groups were allowed to continue standard anti-inflammatory drugs. After 3 months, the double-blind code was broken and remedies were given to members of the placebo group in a single crossover study. Articular index, limbering up time, grip strength and pain all showed statistically significant differences.

In this trial, 65 sufferers of Osteoarthritis (OA) were split into 2 groups, and through a double blinding process were given either a homoeopathic medicine or Acetaminophen, a commonly prescribed drug for pain relief in OA. Researchers found that homoeopathy provided a level of pain relief that was superior to Acetaminophen, and produced no adverse reactions.

A double-blind, randomised, placebo-controlled trial of individualised homeopathic treatment (LM potency) versus placebo in 53 patients, concluded that individualised homeopathy is significantly better than placebo in lessening tender point pain, improving the quality of life and overall health, and less depression of persons with fibromyalgia. A broad selection of homeopathic medicines in LM-potencies were prescribed and the trial was carried out over a 4 month period.

In a randomised placebo-controlled trial of patients with fibrositis, only those patients in whom Rhus toxicodendron was ‘unequivocally indicated’ were admitted to the study. After 1 month’s treatment, there were highly significant improvements in objective and subjective parameters.

A study of 200 patients suffering from hypersensitivity illnesses, including asthma, eczema, urticaria, hay fever and other allergies, showed that homeopathy was at least as effective as conventional treatment. The study, which was retrospective and comparative, looked at the experienced effect in everyday clinical practice of general practitioners and classical homeopaths. Where most patients who were treated by medical doctors experienced an aggravation of their symptoms when stopping conventional drugs, only 1/3 of patients in the homeopathy group experienced such an aggravation (P = 0.002). Only one patient on conventional treatment experienced improvement of symptoms after stopping medication, compared to improvement in 2/3 of homeopathy patients. Patients in the homeopathy group reported a larger improvement in their general state of health, with 57% improving, compared to 24% in the conventional group (difference P = 0.004). Homeopathy patients also experienced more positive change in their psychological state (P<0.0001). For quality of life 53% in the homeopathy group improved, compared to 15 % in the conventional group.

Reilly and colleagues have conducted a series of trials in patients with hay fever, asthma and perennial rhinitis. Patients were given skin tests and remedies were chosen on the basis of reactivity. This design allows individualisation whilst avoiding the issues of case-taking and the effect that this has on the process. The results demonstrate a significant difference between the placebo and homeopathic groups which is reproducible. (NB! Strictly speaking these are trials of isopathy.)